The establishment of overdose prevention centers (OPCs) –– places where individuals can use illegal opioids (obtained elsewhere) near trained staff ready to intervene in case of an overdose –– faces mixed public support in the United States. A study published in December 2021 found wider support nationally than at the local level, indicating some “Not In My Backyard” concerns.
Despite the wealth of scientific data showing that overdose prevention centers, also known as safe injection sites, save lives, improve health outcomes, and help contain the spread of infectious diseases, there are only three officially authorized overdose prevention centers in the United States. Two are in Manhattan and are operated by OnPointNYC. (The third is in Providence, Rhode Island.)
Even as 2022 overdose death numbers remain close to the record-breaking levels seen in the period ending in August 2021, opposition to these sites is wide and bipartisan. The Trump administration’s Department of Justice aggressively opposed OPCs, and last year, California governor Gavin Newsom, a Democrat, vetoed a pilot program that would have created OPCs in San Francisco, Los Angeles and Oakland. Clearly, the stigma against drug users persists. Concerns about increased crime rates in neighborhoods hosting these sites are also a factor, even though, so far, there isn’t any evidence proving that OPCs lead to increased crime rates in their vicinity.
The documentary “Love in the Time of Fentanyl,” available for on all streaming platforms, refutes most clichés about drug addiction and overdose prevention centers, while never turning away from the urgency and intrinsically difficult aspects of the topic. Directed by Colin Askey, the film profiles workers and clients of an OPC in Vancouver, Canada, set up by a group of activists and drug users attempting to tackle record drug overdose deaths in the city.
The film splits its focus between OPS workers, all of them former or current drug users, and the community they serv. “The only difference between you and I is one bad decision,” says a current drug user and ex-oil rig worker who got laid after oil prices plunged. Then, when his wife was killed by a drunk driver, “doing down was easier than dealing with it.”
Later in the film, another male user opens up about his service in Afghanistan to Ronnie, one of OPS’s most inspiring and dedicated staffers. Minutes after injecting himself, he talks about his experience in the Canadian-led Operation Medusa, in Afghanistan, which “claimed the lives of 159 Canadian soldiers.” HIs best friend, Josh Klukie, was among the fatalities. Before dozing off he points to Josh’s name tattooed on his skin. Here, the mere act of listening to that story, could make a difference in this man’s life.
Although Askey introduces some fascinating key characters, including Norma, an indigenous woman who cooks meals for the staff, and Trey, a former heroin user who now memorializes victims of overdose with graffiti, his camera is more interested in small, intimate moments, interpersonal exchanges, and capturing what bonds this community together. By choosing this approach, Askey not only does justice to his subjects, but also portrays them as eloquent and self-aware human beings surrounded by both tenderness and dread.
According to CDC data, drug overdose deaths in the U.S. peaked in the calendar year ending in August 2021. But while data for the next 12 months show a nominal national decrease, drug overdose deaths in New York City, for instance, continue to grow. According to a CDC map, the city has experienced an increase of 17.85% between the 2021 and 2022 calendar years.
But there’s reason to be optimistic. Both the Washington Post and the New York Times editorial boards have come out in favor of OPCs, and the official New York sites have intervened in more than “700 overdose interventions,” according to OnPointNYC, and there were no deaths at the facilities. BIden’s DOJ is also signaling it might revert its position and allow OPCs to be established.
Discussions about the effectiveness of safe injection sites also need to acknowledge the abysmal failure of the war on drugs –– and frame the rise in drug overdose deaths as a public health issue, first and foremost. We then just need policymakers and political leaders to have the courage to prioritize the health of the public over their own careers.